Writing for the Salem Statesman-Journal, Peter Wong’s is a based on a recent visit by Gov. John Kitzhaber to the paper’s editorial board:
Health care overhaul
As the chief legislative author of a 1989 proposal that transformed a traditional Medicaid program into a broader Oregon Health Plan, covering all Oregonians under the federal poverty level with basic services, Kitzhaber has long been identified with the issue.
But times have changed — after Kitzhaber left office the first time in 2003, the plan no longer covers every low-income person — and costs have soared.
For the past two years, federal stimulus funds have helped Oregon and all states pay for Medicaid. But Congress did not renew the extra funds — and Oregon is among the states that cut payments to doctors, hospitals and other providers, Oregon by an average of 11.5 percent in the first year of the budget cycle that started July 1.
Kitzhaber said the alternatives to what he has proposed are to reduce payments further in the second year, or lop recipients from coverage. Neither is acceptable, he said, because one would result in fewer providers and the other in more patients using hospital emergency rooms.
“We know that 85 percent of the cost of the health-care system comes from the management of people with chronic conditions, and that 10 percent of the population accounts for 70 percent of the costs,” he said. “What we are trying to do is identify the people who bounce in and out of the hospital on a frequent basis and manage them with a community-based team approach, which is not new.”
Kitzhaber has pointed to a project in central Oregon, where his current health-care adviser, Mike Bonetto, was once a vice president of St. Charles Health System. He said that the Mid-Valley Independent Physicians Association could be an example of the kind of coordinated-care organization that he has in mind.
Kitzhaber said even though only Oregon Health Plan recipients are affected, success of the new system would be a model for restraining the costs of health care.
Some lawmakers were skeptical of the $240 million savings estimated for the second year of the budget. But they went ahead and approved a framework for which the Oregon Health Authority must provide details by the February session.
“I think people recognize the current system is not sustainable, and we’re going to have to change it,” Kitzhaber said. “The question is whether we can change it fast enough to realize these savings. I do not know the answer to that. But I am confident we have the capacity to do it.”
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